Locked in the Vault — Survivor Guilt in Combat Veterans

By J. Scott Janssen, MSW, LCSW

Chris thought she’d heard all her father Joe’s stories about World War II. She knew everything from the fear he felt landing on the beaches of Normandy to his joy when the war finally ended and he was still in one piece. But it turns out she really hadn’t heard them all.

As Joe’s kidney failure progressed, he began to recall memories he hadn’t shared. When, as his hospice social worker, I arrived one day for a visit, I could see something was on his mind. He lacked his typical friendliness and eagerness to engage. He seemed sad, possibly depressed, but said he was just feeling “off.” I asked if he could help me understand what he meant, and he said he was feeling “a kind of heaviness I can’t really explain.”

I asked if he could locate the heaviness in his body. He pointed to his chest around his heart. “It’s tight right around here.”

“Feel the heaviness, Joe,” I suggested. “Notice what’s going on there.” When he was focused on the feeling in his chest, I asked him to tell me the first thought or image that popped into his head.

Tears started rolling down his face. “Billy Johnson,” he said. Our exchange slowed as powerful emotions churned. I asked if he was remembering a specific event; he nodded.

“Are you with him, Joe?”

He nodded.

“Where are you?” I whispered.

“Omaha Beach.”

“What’s happening?”

“He’s bleeding to death. His legs are gone.”

Chris had never heard her father mention Billy Johnson. Every friend Joe had ever told her about had survived the war. He’d never mentioned any who’d been killed. Now, as he faced his own impending death, Joe was ready to share some of their stories—stories that had always been with him but never spoken.

What most surprised Chris was Joe’s guilt about surviving the war when so many of his friends had not. “Sometimes I think I should have died there, too,” Joe said. “It’s not fair that I lived and they didn’t. I still feel guilty sometimes.”

The Bond
Survivor guilt is common with trauma where there is one or more deaths and is especially common for those who survive combat, where such losses may be cumulative.

To enhance our sensitivity about how such guilt can haunt those who return from war, we must start with the fact that deep bonds of affection and trust often form when soldiers are joined into a single unit and thrust together into the chaotic violence of combat. Tensions can flare and nerves fray at times, but when the battle begins, they must work together and watch each other’s backs.

With the stakes being life and death, with a code of behavior valuing solidarity and mutual protectiveness, it is no surprise that countless service members have spoken about the friendships formed under such adversity as being among the strongest and most enduring of their lives. When such a friend is killed, the loss can be felt as significantly and painfully as the death of a family member.

The Arbitrariness of Death
Another aspect to consider is the indiscriminant way death occurs on a battlefield. Though many soldiers arrive in theaters of war believing they have foolproof strategies for survival—special skills, knowledge, qualities, or protection—such notions often vanish after one or two combat engagements. Amidst the terror of battle, someone’s vulnerability and susceptibility to sudden death soon becomes clear. After witnessing how quickly and seemingly arbitrarily death occurs while others are left standing, most soldiers soon realize that it can indeed happen to them.

When close friends die in battle, there may be in the back of a survivor’s mind a keen awareness that the fates could have been reversed. As grieving survivors construct personal stories and meanings while trying to understand such events, it is easy to understand how questions arise, such as “Why him and not me? Why was he the one to pay the ultimate price? Why did my luck hold where his ran out?”

Honoring the Fallen
Another common aspect of grief is a tendency to idealize those who have died, often overlooking less admirable details in a conscious or unconscious attempt to honor and respect them. When the deceased are young soldiers killed in the line of duty, such sacrifices can fortify this tendency to see only what was good in the one who has died.

There is nothing inherently wrong with such honor-based narrations; they spring from a place of caring and love. But by idealizing those who have fallen in battle, combat survivors may inadvertently set the bar higher than most humans can attain as they measure the course of their own lives over time, especially if war has shaken them in ways that make it hard to find peace. When survivors make such mental comparisons, contrasting their lives years later with the imagined life of a friend who was killed, they may wonder, “Why did he die when he was such a good person and had so much to live for, so much possibility, while I survived and just can’t seem to get my act together?”

Taken together, the closeness of the bond, the realization that who lives and dies in battle has an aspect that is chillingly random, and the tendency to idealize those who are killed and see only the best possibilities in the lives that were suddenly lost is a mix that breeds guilt in survivors. Such guilt may be intensified by the complicated grief and posttraumatic stress that often plagues combat survivors. Some even walk away feeling personal responsibility for deaths specifically or in general.

Though using standard clinical lenses, such as understanding survivor guilt within the context of trauma, complicated grief, or depression, can be helpful, we must not forget that these experiences go to the deepest layers of the self. Edward Tick reminds us in his book War and the Soul: Healing Our Nation’s Veterans From Post-Traumatic Stress Disorder that the impact of war can cause more than psychological and emotional pain; it can shake us to the existential core, leaving what he calls a “soul wound, affecting the personality at the deepest levels.”

How Social Workers Can Support Healing
How can social workers support women and men carrying such guilt? In practical terms, it helps to know something about the nature of guilt and the constellation of thoughts, beliefs, and feelings that often spiral around it. It helps to know something about grief and trauma, and it can help for someone to become familiar with military culture as much as possible.

Many have highlighted the (often-profound) value of veterans finding opportunities for community and sharing with other combat survivors and of the power of ritual in fostering forgiveness and healing, opportunities which may be explored and encouraged.

In a general sense, it is important not to judge or jump quickly to conclusions. When we see such palpable emotional and psychological pain, it may be tempting to search for its origins in cognitive distortion, displaced anxiety churning beneath the surface or some dysfunction. But first we must seek to understand what the guilt means to the one who carries it.

For some, survivor guilt is not complicated grief; it is a vital pulsation of unbroken affection. To some it signifies loyalty to “those who have fallen.” For others, it may be a lingering cry of protest against the unfairness of lives being savagely cut short. If social workers are to help combat veterans disentangle themselves from the pain, we must first know what it means to them.

When I asked Joe what it would mean to him if he woke up one day and the guilt he felt at surviving the war was gone, he said it would mean betraying the memory of his fallen friends. Before we could find ways to lessen the pain, we first had to explore ways he could honor these friends that no longer required guilt as a sign of his fidelity.

Don’t be in a hurry. Sometimes when we sense another’s pain, we may feel an impulse to rush in and try to comfort or probe for insight. Traumatic memories can be very intense and vivid. Before inviting exploration, establish a sense of safety and trust where there are no judgments and no pressure. Let the veteran control the pace and tempo of such explorations. It is not social workers’ job to force someone to go where he or she does not want to go, though we may communicate that we care and that it is safe to do so if the person so chooses.

Be ready to listen compassionately to the stories without flinching, even when they are painful to hear. One way to work with the mind’s tendency to keep the past alive by replaying painful stories, images, and memories (and, in the case of trauma, the nervous system’s tendency to replay intense somatic upset) is for these stories to be released from the deep inner vaults where they are often stored, to share them in a context that is loving, respectful, and affirmative.

Though we may not be platoon brothers and cannot fully understand what it means to survive combat, as social workers, we may find ourselves standing beside someone like Joe. When we do, it is not our job to try to force the vault open. But if we remember the healing power of attuning to another’s inner experience in ways that communicate that it’s safe, that we care, that we are prepared to listen without judgment, to bear witness, we will be ready if the vault cracks ever so slightly ajar.

— J. Scott Janssen, MSW, LCSW, has been a hospice social worker for 20 years and currently works for Duke Hospice in Durham, NC. He authored the book The Dawn Is Never Far Away: Stories of Loss, Resilience, and the Human Journey.